Chronic osteomyelitis - Revision history

Aidan at 17:27, 19 September 2024

2024-09-19T17:27:49Z

← Older revision		Revision as of 17:27, 19 September 2024
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	== Investigations ==		== Investigations ==

	* CT is better than MRI for imaging for bony sequestrum~~<ref>Gaillard F, Bell D, Knipe H, et al. Bony sequestrum. Reference article, Radiopaedia.org (Accessed on 16 Jan 2023) doi:~~ [~~https~~:~~//doi.org/10.53347/rID-7664 10.53347/rID-7664~~]~~</ref>~~		* CT is better than MRI for imaging for bony sequestrum[[CiteRef::bickle2009bo]]

	==Management==		==Management==
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	* In general, typically treated with 4 to 6 weeks of parenteral or highly bioavailable therapy followed by step-down to oral therapy to complete total of 4 to 12 weeks		* In general, typically treated with 4 to 6 weeks of parenteral or highly bioavailable therapy followed by step-down to oral therapy to complete total of 4 to 12 weeks
	** [[TMP-SMX]] or a fluoroquinolone is preferred oral therapy		** [[TMP-SMX]] or a fluoroquinolone is preferred oral therapy
	** There is no evidence that antibiotic therapy longer than 4 to 6 weeks improves outcomes<ref>Brad Spellberg , Benjamin A. Lipsky, Systemic Antibiotic Therapy for Chronic Osteomyelitis in Adults, ''Clinical Infectious Diseases'', Volume 54, Issue 3, 1 February 2012, Pages 393–407, https:~~//doi.org/10.1093/cid/cir842</ref>~~		** There is no evidence that antibiotic therapy longer than 4 to 6 weeks improves outcomes[[CiteRef::spellberg2011sy]]
	* Some recommend adding [[rifampin]] for ''[[Staphylococcus aureus]]'', especially if hardware is involved		* Some recommend adding [[rifampin]] for ''[[Staphylococcus aureus]]'', especially if hardware is involved

Aidan at 13:48, 16 August 2023

2023-08-16T13:48:59Z

← Older revision		Revision as of 13:48, 16 August 2023
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	* Ideally get bone biopsy for culture prior to starting antibiotics		* Ideally get bone biopsy for culture prior to starting antibiotics
	* In general, typically treated with 4 to 6 weeks of parenteral or highly bioavailable therapy followed by step-down to oral therapy to complete total of 4 to 12 weeks		* In general, typically treated with 4 to 6 weeks of parenteral or highly bioavailable therapy followed by step-down to oral therapy to complete total of 4 to 12 weeks
	** [[TMP-SMX]] or a fluoroquinolone is preferred oral ~~thereapy~~		** [[TMP-SMX]] or a fluoroquinolone is preferred oral therapy
			** There is no evidence that antibiotic therapy longer than 4 to 6 weeks improves outcomes<ref>Brad Spellberg , Benjamin A. Lipsky, Systemic Antibiotic Therapy for Chronic Osteomyelitis in Adults, ''Clinical Infectious Diseases'', Volume 54, Issue 3, 1 February 2012, Pages 393–407, https://doi.org/10.1093/cid/cir842</ref>
	* Some recommend adding [[rifampin]] for ''[[Staphylococcus aureus]]'', especially if hardware is involved		* Some recommend adding [[rifampin]] for ''[[Staphylococcus aureus]]'', especially if hardware is involved

Aidan at 20:54, 16 January 2023

2023-01-16T20:54:49Z

← Older revision		Revision as of 20:54, 16 January 2023
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	** [[Non-tuberculous mycobacteria]]		** [[Non-tuberculous mycobacteria]]
	** Fungi		** Fungi

			== Investigations ==

			* CT is better than MRI for imaging for bony sequestrum<ref>Gaillard F, Bell D, Knipe H, et al. Bony sequestrum. Reference article, Radiopaedia.org (Accessed on 16 Jan 2023) doi: [https://doi.org/10.53347/rID-7664 10.53347/rID-7664]</ref>

	==Management==		==Management==

Aidan: Text replacement - " species]]" to "]]"

2022-01-28T16:28:38Z

Text replacement - " species]]" to "]]"

← Older revision		Revision as of 16:28, 28 January 2022
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	* ''[[Staphylococcus aureus]]''		* ''[[Staphylococcus aureus]]''
	* [[Coagulase-negative staphylococci]]		* [[Coagulase-negative staphylococci]]
	* [[Streptococcus ~~species~~]]		* [[Streptococcus]]
	* [[Enterococcus ~~species~~]]		* [[Enterococcus]]
	* ''[[Pseudomonas aeruginosa]]''		* ''[[Pseudomonas aeruginosa]]''
	* Gram-negative [[Enterobacteriaceae]]		* Gram-negative [[Enterobacteriaceae]]

Aidan: Created page with "==Background== * Osteomyelitis that involves necrotic bone, usually suggested by treatment failure, symptoms lasting three or more weeks, presence of sequestrum, persistent dr..."

2020-06-22T11:49:11Z

Created page with "==Background== * Osteomyelitis that involves necrotic bone, usually suggested by treatment failure, symptoms lasting three or more weeks, presence of sequestrum, persistent dr..."

New page

==Background==
* Osteomyelitis that involves necrotic bone, usually suggested by treatment failure, symptoms lasting three or more weeks, presence of sequestrum, persistent drainage, or sinus tract

===Microbiology===
* ''[[Staphylococcus aureus]]''
* [[Coagulase-negative staphylococci]]
* [[Streptococcus species]]
* [[Enterococcus species]]
* ''[[Pseudomonas aeruginosa]]''
* Gram-negative [[Enterobacteriaceae]]
* [[Anaerobes]] including ''[[Cutibacterium acnes]]''
* Unusual pathogens:
** After animal bite: ''[[Pasteurella multocida]]'', ''[[Eikenella corrodens]]''
** If risk factors: [[tuberculosis]]
** [[Non-tuberculous mycobacteria]]
** Fungi

==Management==
* Ideally get bone biopsy for culture prior to starting antibiotics
* In general, typically treated with 4 to 6 weeks of parenteral or highly bioavailable therapy followed by step-down to oral therapy to complete total of 4 to 12 weeks
** [[TMP-SMX]] or a fluoroquinolone is preferred oral thereapy
* Some recommend adding [[rifampin]] for ''[[Staphylococcus aureus]]'', especially if hardware is involved

[[Category:Bone and joint infections]]